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    Non-Odontogenic Tumor (Lecture)

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    shabeelpn
    This document discusses various non-odontogenic tumors that can occur in the jaws, categorizing them as benign or malignant. It covers osteogenic tumors like osteoma, osteoid osteoma, osteoblastoma, and osteosarcoma. It also discusses cartilaginous tumors such as chondroma, chondromyxoid fibroma, and chondrosarcoma. Other tumor types mentioned include fibrous tumors, vascular tumors like hemangioma, Ewing's sarcoma of unknown origin, and metastatic tumors. Most benign tumors are treated with surgery while malignant tumors may require additional chemotherapy or radiation therapy.

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    Non-Odontogenic Tumor (Lecture)

    Uploaded by

    shabeelpn
    5K views64 pages
    This document discusses various non-odontogenic tumors that can occur in the jaws, categorizing them as benign or malignant. It covers osteogenic tumors like osteoma, osteoid osteoma, osteoblastoma, and osteosarcoma. It also discusses cartilaginous tumors such as chondroma, chondromyxoid fibroma, and chondrosarcoma. Other tumor types mentioned include fibrous tumors, vascular tumors like hemangioma, Ewing's sarcoma of unknown origin, and metastatic tumors. Most benign tumors are treated with surgery while malignant tumors may require additional chemotherapy or radiation therapy.

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    This document discusses various non-odontogenic tumors that can occur in the jaws, categorizing them as benign or malignant. It covers osteogenic tumors like osteoma, osteoid osteoma, osteoblastoma, and osteosarcoma. It also discusses cartilaginous tumors such as chondroma, chondromyxoid fibroma, and chondrosarcoma. Other tumor types mentioned include fibrous tumors, vascular tumors like hemangioma, Ewing's sarcoma of unknown origin, and metastatic tumors. Most benign tumors are treated with surgery while malignant tumors may require additional chemotherapy or radiation therapy.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    5K views64 pages

    Non-Odontogenic Tumor (Lecture)

    Uploaded by

    shabeelpn
    This document discusses various non-odontogenic tumors that can occur in the jaws, categorizing them as benign or malignant. It covers osteogenic tumors like osteoma, osteoid osteoma, osteoblastoma, and osteosarcoma. It also discusses cartilaginous tumors such as chondroma, chondromyxoid fibroma, and chondrosarcoma. Other tumor types mentioned include fibrous tumors, vascular tumors like hemangioma, Ewing's sarcoma of unknown origin, and metastatic tumors. Most benign tumors are treated with surgery while malignant tumors may require additional chemotherapy or radiation therapy.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 64

    Non-odontogenic tumors

    Benign
    1)Osteogenic tumor- Osteoma Osteoid osteoma & Osteoblastoma 2)Cartilagenous tumor-Chondroma -Chondromyxoid fibroma 3)Fibrous tumor Desmoplastic fibroma 4) Vascular tumor Hemangioma 5)Unknown ORIGIN- Ewing s sarcoma 6)Metastatic tumor

    Malignant
    Osteosarcoma

    Chondrosarcoma Fibrosarcoma

    Non-odontogenic tumors

    Osteogenic tumor

    Benignancy Malignancy 1. Osteoma 3. Osteosarcoma 2. Osteoid osteoma& Osteoblastoma

    Osteogenic Tumor
    1. Osteoma Clinical & Radiographic Features slow growing,usually asymptomatic tumor periosteal or endosteal osteomas radiographically: presenting as a circumscribed sclerotic mass consistent with bone density depending on the tumor s component can be associated with Gardner s syndrome (multiple osteoma, intestinal polyposis leading to colon CA)

    Histopathologic Features compact osteoma: dense bone with minimal marrow tissue cancellous osteoma: trabeculae with fibro-fatty marrow Treatment & Prognosis do not need to be treated, if no symptom

    Compact osteoma

    Compound osteoma

    Multiple osteoma associated with Gardners syndrome

    Osteogenic Tumor
    2. OSTEOID OSTEOMA & OSTEOBLASTOMA

    identical lesions, but distinguished from one another by location, size, and symptomatology

    Clinical & Radiographic Features


    Osteoid osteoma rare in the jaws most occurring in femur, tibia, phalanges usually presenting as pain in the night, alleviated by salicylate(aspirin) appearing as a well - circumscribed radiolucent defect,usually<1cm(not more than 2 cm) in diameter, with sclerotic rim a small radiopaque nidus may be present

    Osteoblastoma
    most often occurring in vertebral column, but may involve any bone, mandible:maxilla = 2:1 2-4cm in size, but may be as large as 10cm presenting with pain, but less often nocturnal and not relieved by aspirin may appear as a well- defined or ill - defined radiolucent lesion.

    Histopathologic Features

    anastomosing osteoid trabeculae in a cellular fibrovascular stroma the osteoid trabeculae, which often appearing basophillic surrounded by prominent osteoblasts

    Treatment and Prognosis


    local excision or curettage good prognosis

    Nidus

    Aggressive Osteoblastomas
    more often in older patients common symptom: pain lesion: the features of conventional osteoblastomas but tend to be larger microscropically, characterized by the presence of large (epithelioid) osteoblasts with increased mitotic activity

    Osteogenic Tumor
    3. Osteosarcoma

    The distal femur and proximal tibia: the most frequent sites 7% : occurring in the jaws

    Clinical & Radiographic Features


    most often occurring in the third and fourth decades of life males > females swelling and pain loosening of teeth, paresthesia, and nasal obstruction young children to the elderly varying from dense sclerosis to admixed sclerotic and radiolucent lesion, to an entirely radiolucent process, ill defined and indistinct margin

    Histopathologic Features
    production of osteoid by malignant m e s e n c h y m a l c e l l s o s t e o b l a s t i c c h o n d r o b l a s t i c f i b r o b l a s t i c T r e a t m e n t & P r o g n o s i s r a d i c a l s u r g i c a l e x c i s i o n s u p p l e m e n t e d : c h e m o t h e r a p y, radiation therapy or both

    Typical sun-ray appearance

    Osteogenic Tumor
    Peripheral (juxtacortical) Osteosarcoma usually occurring in the long bones a few examples involving the jaws the parosteal type of osteosacroma is characterized by a high degree of structural differentiation the periosteal type of osteosacroma : a histopathologically higher grade of tumor with a prominent cartilaginous component

    Osteogenic Tumor
    Post - Irradiation Bone Sarcoma develop as early as 3 years after radiation, but the average latent period is about 14 years 0.2% Pt: receiving 7000 rad (cGy) osteosacroma is the most common type of Post - irradiation Bone Sacroma, accounting for 50% of all cases

    Terry Fox 1958-1981

    Benignancy Cartilagenous tumor


    1. Chondroma

    Malignancy
    3. Chondrosarcoma

    2. Chondromyxoid fibroma

    Cartilagenous Tumor

    1. Chondroma
    mature hyaline cartilage most often located in the short tubular bones of the hand and the feet. rarely been reported in the jaws. Histopathological Features mature cartilage very difficult to distinguish from low grade chondrosarcoma

    Chondroma

    Treatment and Prognosis


    total surgical removal of the tumor

    2. Chondromyxoid Fibroma benign neoplasm.


    most commonly located in the metaphyseal region of the long bones. rarely involving in the jaws.

    Clinical and Radiographic Feature


    age: 10 - 67 years old. most often: under age 25 years old. pain or expansion of the involved area. asymptomatic. presenting as a circumscribed radiolucent defect with sclerotic or scalloped margins calcification.

    Histopathological Features
    consisting of lobulated areas of spindle shaped or stellate cells and abundant myxoid or chondroid intercellular substance. spindle - shaped or round cells with varying numbers of multinucleated cells. focal areas of calcification and spicules of residual bone.

    block excision as the initial treatment. curettage.

    Treatment and Prognosis

    3. Chondrosarcoma
    malignant neoplasm. most commonly located in the metaphyseal region of the long bones. rarely involving in the jaws.

    Clinical and Radiographic Feature


    wide age range average age: 33 years the most common presenting as painless or swelling mass the maxilla and mandible involved with about equal frequency a radiolucent process with poorly defined borders containing scattered and variable amounts of radiopaque foci

    Histopathological Features
    consists of cartilage with varying degree of maturation and cellurarity, and showing lobulated growth pattern ossification, calcification and chondroid matrix

    Treatment and Prognosis


    r a d i c a l s u r g i c a l e x c i s i o n poorer prognosis than osteosarcoma of the jaws

    Non-odontogenic tumors
    Benignancy Fibrous tumor Desmoplastic fibroma Malignancy Fibrosarcoma

    Fibrous Tumor
    1. Desmoplastic Fibroma
    rare tumor humerus and tibia > 50 %

    Clinical and Radiographic Features

    age: < 30 years old. 90% in the mandible: the molar - angle ascending - ramus area. Painless swelling. Unilocular or multiocular radiolucent area. well defined or ill defined Margins expanded cortex roots: resorption.

    Histopathological Features
    small elongated fibroblasts and abundant collagen fibers. plumper fibroblasts and less collagen. bone spicules may be present.

    Treatment and Prognosis


    locally aggressive fashion. radical surgery.

    A. Odontogenic fibroma vs B. Desmoplastic fibroma

    2. Fibrosarcoma of Bone
    one of the least common types of primary bones sarcomas
    Clinical and Radiographic Features a wide age rang ( average 40 years old) No gender predilection

    most commonly occurring in the long tubular bones, particularly the femur and humerus 15% in the craniofacial bones, and mandible being the predominant site pain, swelling, paresthesia, and loosening of teeth presenting as lytic, destructive lesions

    Histopathological Features
    low - grade tumors characterized by abundant intercellular collagen with a herringbone pattern

    Fibrosarcoma extending from the soft tissue to the bone

    high - grade tumors showing cellular pleomorphism, increased mitotic activity, loss of the herringbone pattern, and less collagen formation

    Treatment and Prognosis


    radical resection
    prognosis for tumors originating in the medullary portion of the bone being poorer than for those arising in a periosteal position

    NonNon-Odontogenic Tumors Tumors

    Vascular tumor

    Hemangioma a

    Vascular Tumor
    Hemangioma of Bone
    Central hemangiomas
    Clinical and Radiographic Features
    age: 10 - 20 years old. female > Male twice as often in the mandible as the maxilla. asymptomatic pain and swelling.

    Clinical and Radiographic Features


    a bruit or pulsation most commonly, a multilocular radiolucent defect. small (honeycomb appearance) or large (soap bubble appearance). ill - defined radiolucent area or a well - defined, cyst - like radiolucency. resorption of the roots cortical expansion, and occasionally a sunburst radiographic pattern is produced.

    Cavernous hemangioma

    Histopathological Features
    fibrous connective tissue stroma supporting numerous vascular channels lined with a single layer of endothelial cells.

    Treatment and Prognosis


    potentially dangerous lesions because of the risk of severe bleeding. surgical resection or curettage, cryotherapy, radiation, or injections of sclerosing solution presurgical embolization. good prognosis.

    NonNon-Odontogenic Tumors Tumors

    Unknown origin

    Benignancy Malignancy Ewing s sarcoma

    Unknown Origin
    Ewing s Sarcoma
    Clinical and Radiographic Features
    6-10% of all primary bone tumors femur and pelvic bones: nearly 50% of all cases < 3% involving jaws bones 80% occurring in 10-20 Y/O, male;female=3:2 mandible>maxilla paresthesia and loosening of teeth

    irregular lytic bone destruction with ill-defined margin long bones onion-skin periosteal reaction: commonly observed in long bones

    Histopathological Features small round with well-delineated nuclear outline and indistinct cellular border 75% of cases containing glycogen in tumor cells

    Ewings sarcoma

    Treatment and Prognosis


    surgery, radiotherapy and chemotherapy leading to 40-80% survival rates

    Metastatic Tumors to The Jaws


    primary carcinomas of thyroid, breast, kidney, lung and prostate usually metastasizing to bones jaws bones: uncommon site for metastasis, but if occuring 80% found in the mandible

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